Claims Administrator at EmpowerFS

3 days ago


Midrand, Gauteng, South Africa EMPOWER FINANCIAL SERVICES Full time

Claims Administrator

Responsibilities

  • Assess claims according to the rules, benefits, and conditions of the policy and within the SLA.
  • Request outstanding information from clients (telephonic & e-mail).
  • Contact service providers for discounts when claims are over the company prescribed threshold.
  • Ensure that all policy limitations, waiting periods, and exclusions are appropriate and in line with the policy.
  • Attend to customer queries.
  • Any other duties as assigned by your manager from time to time.

Skills

  • Computer Literacy

Technical Competencies

  • Insurance industry knowledge: Understanding of life insurance policies, funeral insurance, and relevant regulations.
  • Claims processing: Familiarity with claims procedures, assessment, and settlement practices.
  • Funeral industry awareness: Knowledge of funeral services, customs, and traditions.

Interpersonal and Communication Skills

  • Empathy and compassion: Ability to provide sensitive support to bereaved families.
  • Effective communication: Clear, concise, and respectful communication with clients, funeral homes, and other stakeholders.
  • Conflict resolution: Ability to handle disputes or complaints in a professional and diplomatic manner.

Excel Analytical Skills

  • Data entry: Accurate and efficient data entry for claims information, policy details, and beneficiary data.
  • Data validation: Ability to validate data for accuracy, completeness, and consistency.
  • Data analysis: Basic analytical skills to review and interpret claims data.

Excel Functions and Formulas

  • Basic arithmetic operations: Proficiency in using basic arithmetic operations like sum, average, and count.
  • Conditional logic: Understanding of IF statements and other conditional logic functions.
  • Lookup and reference: Ability to use vlookup, index-match, and other look-up and reference functions.

Excel Tools and Features

  • PivotTables: Basic understanding of pivot tables to summarize and analyze claims data.
  • Charts and graphs: Ability to create basic charts and graphs to visualize claims data.
  • Excel formulas and functions: Familiarity with other Excel formulas and functions, such as text, date, and time.
  • Attention to detail: Accurate assessment and processing of claims, with attention to policy details and documentation.
  • Analytical thinking: Ability to interpret policy terms, assess claim validity, and make informed decisions.

Personal Qualities

  • Integrity and professionalism: Maintenance of confidentiality, impartiality, and a high level of professionalism.
  • Adaptability and flexibility: Ability to work in a fast-paced environment, adapt to changing circumstances, and prioritize tasks effectively.
  • Emotional resilience: Capacity to manage the emotional demands of working with bereaved families and handling sensitive or distressing situations.

Desired Education Level

  • Grade 12/Matric.
  • A Diploma in FAIS Compliant, RE5 Certificate or a related field can be added as an advantage.

Job Type: Full-time
Salary: Negotiable based on experience, qualifications, and current work status.

Desired Skills

  • Claims Administration

Desired Work Experience

  • 2 to 5 years
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